%0 Journal Article
%T Current Practices in Prescribing Auto-Injectable Epinephrine during Immunotherapy amongst Otolaryngic Allergists
%A Kareem B. Haroun
%A Duncan C. Watley
%A Farrah N. Siddiqui
%J International Journal of Otolaryngology and Head & Neck Surgery
%P 258-267
%@ 2168-5460
%D 2021
%I Scientific Research Publishing
%R 10.4236/ijohns.2021.104024
%X <strong>Purpose:</strong> Allergen immunotherapy (AIT) while usually safe, is not without risk. Both sublingual (SLIT) and subcutaneous immunotherapy (SCIT) have the potential for systemic reactions including anaphylaxis. <strong>Materials and Methods:</strong> A short survey was distributed to fellows of the American Academy of Otolaryngic Allergy (AAOA) (n = 553) in July of 2019 to determine current prescribing practices. <strong>Results:</strong> A total of 103/553 surveys were completed, giving a response rate of 18.6%. Prescribing patterns for SCIT showed 79.6% prescribed auto-injectable epinephrine (AIE) to all patients, 11.7% prescribed only to high risk patients, while 1.9% did not prescribe AIE at all. SLIT showed similar patterns with 71.8% prescribing AIE to all, 11.7% to high risk or letting patient choose, and 6.8% did not prescribe to anyone. Just under half of the physicians responded affirmatively to giving a written anaphylaxis plan to patients on immunotherapy. 48.5% physicians reported treating in-office anaphylaxis due to SCIT or skin testing in the past year, while 6% reported anaphylaxis due to SLIT. <strong>Conclusions:</strong> A majority of otolaryngic allergists are still prescribing AIE for both SCIT and SLIT. With the recent higher costs attributed to AIE as well as drug shortages, some physicians are risk-stratifying patients. While SCIT has a higher risk for treatment related systemic reactions, anaphylaxis does occur with SLIT, thus making it imperative to counsel patients on a clear anaphylaxis protocol in all forms of AIT.
%K Allergy
%K Immunotherapy
%K Sublingual Immunotherapy
%K Subcutaneous Immunotherapy
%K Anaphylaxis
%K Epinephrine
%K Auto-Injectable Epinephrine
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=110333